MENETRIER’S DISEASE

• Large gastric folds due to excessive mucous cells, and edematous mucosa often with shallow ulceration

• A rare cause of protein-losing enteropathy

• The exact etiology of the disease is unknown

• CMV infection has been documented in one third of pediatric cases

Hypertrophic gastropathy or Menetrier’s disease

Mentrier’s disease is a rare cause of protein-losing enteropathy in children, but over the last decade the number of published cases has doubled. The exact etiology of the disease is unknown. CMV infection has been documented in one third of pediatric cases.

In children with Menetrier’s disease, EGD shows an enormous amount of gelatinous mucus in the stomach, giant gastric rugae in the fundus or gastric body that remain unchanged despite vigorous insufflation, and edematous mucosa often with shallow ulceration. Histological signs of Menetrier’s disease are: mucus filled dilated gastric glands; basilar cystic changes, and mixed infiltration of lamina propria with neutrophils, lymphocytes, eosinophils and plasma cells occasionally. A unique feature of Menetrier’s disease in children is complete resolution of the symptoms and pathological changes of the gastric mucosa with adequate therapy in the majority of patients.